C. difficile and antibiotics not necessarily linked

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Public release date: 6-Oct-2008

http://www.eurekalert.org/pub_releases/2008-10/muhc-cda093008.php

Contact: Isabelle Kling

isabelle.kling@...

McGill University Health Centre

C. difficile and antibiotics not necessarily linked

A team at the MUHC and the Jewish General Hospital takes a new look at

the causal relationship between antibiotic use and C. difficile infections

This release is available in French.

Montreal, September 30th, 2008 – The latest study by Dr. Dial

from the Research Institute of the MUHC, McGill University, and

Attending Staff in the Intensive Care Unit at the Jewish General

Hospital, questions the assumption held by a vast majority of medical

professionals that Clostridium difficile (C.difficile) infections are

essentially always preceded by antibiotic use. This finding could have a

major impact on how patients with diarrhea are evaluated upon their

admission to the hospital. This study will appear in the October 6 issue

of the Canadian Medical Association Journal (CMAJ).

The researchers analyzed only C. difficile infections acquired outside

the hospital by patients aged 65 or older, and serious enough to require

a hospitalization. Patients with hospital-acquired C.difficile

infections were excluded because of the increased risk of infection and

antibiotic use in the hospital environment.

Their results show that 53% of the patients studied had not been exposed

to antibiotics during the 45 days preceding their C.difficile-related

hospitalisation. A rate that decreased to 46% when the

pre-hospitalization timeframe analysed was extended to 90 days. " These

figures show that approximately 50% of community-acquired C. difficile

infections are not related to antibiotic use, " explained Dr. Dial.

" While antibiotic use indeed plays an important role, other factors are

likely to also be important. But we still need to determine what these

other risk factors are. "

More precisely, this study demonstrates that the highest risk of C.

difficile infection due to antibiotic use occurs during the 30 days

following treatment. According to Dr. Dial, " Beyond the 45-day period

following treatment, the risk declines significantly " .

" We believe that all patients suffering from diarrhea, particularly if

severe enough to require a hospital visit, should be tested for

C.difficile at their arrival in the hospital. Right now, testing is

mainly done on patients who have taken antibiotics, which probably means

that not everyone is receiving a correct diagnosis, " warned Dr. Dial.

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Dr Dial is the Director of Critical care medicine at the Montreal

Chest Institute of the McGill University Health Centre (MUHC), and a

researcher within the " cardiovascular diseases and critical care " and

the " respiratory health " axis of the Research Institute of the MUHC. She

is also an assistant professor at the Faculty of medicine at McGill

University.

Original article and a short audio interview: http://www.muhc.ca/media/news/

For more information please contact:

Burns

Communications Coordinator

MUHC Public Relations and Communications

rebecca.burns@...

Isabelle Kling

Communications Coordinator (research)

MUHC Public Relations and Communications

isabelle.kling@...

Glenn J. Nashen, Director

Reena Kudhail, Communications Specialist

Public Affairs & Communications

Jewish General Hospital

Tel. x 4120

rkudhail@...

--

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